Healthcare Provider Details

I. General information

NPI: 1134348865
Provider Name (Legal Business Name): COLLEEN MARIE BOWLES D.O
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/24/2007
Last Update Date: 12/31/2024
Certification Date: 12/31/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

516 STRAND ST
FREDERIKSTED VI
00840-3533
US

IV. Provider business mailing address

3701 S BROADWAY
ENGLEWOOD CO
80113-3611
US

V. Phone/Fax

Practice location:
  • Phone: 340-772-0260
  • Fax: 866-373-9926
Mailing address:
  • Phone: 303-360-6276
  • Fax: 303-467-5355

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License Number5221
License Number StateNE
# 2
Primary TaxonomyN
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License NumberDR.0052341
License Number StateCO
# 3
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License Number3338
License Number StateVI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: